scholarly journals The prevalence of diabetic retinopathy, risk factors, visual impairment and ocular status among patients with diabetes mellitus presenting to Berhan Aini National Referral Hospital, Eritrea: A hospital based study

2017 ◽  
Vol 6 (4) ◽  
pp. 37-46
Author(s):  
P Bastola ◽  
F Kahsay ◽  
S Zewengiel ◽  
M M Muguleta

Diabetic Retinopathy (DR) is the most common ocular complication in the diabetic population and the leading cause of blindness amongst working age group. There is a paucity of data about DR and various factors in Eritrea. The study aimed to find the prevalence of diabetic retinopathy, risk factors, visual impairment and ocular status among patients with diabetes mellitus in Asmara, Eritrea. This was a hospital based, Mixed method, descriptive study, all the consecutive patients attending the retina clinic of the hospital were enrolled in the study from January, 2014 to October, 2016. Early Treatment Diabetic Retinopathy Study (ETDRS) and Modified Airlie House classification were followed to evaluate the various stages of diabetic retinopathy and clinically significant macular edema (CSME). The guidelines developed by International Council of Ophthalmology (ICO) were followed to determine the need for interventions. Of the 506 diabetic subjects attending Berhan Aini National Referral Hospital; 435 (86.0%) subjects had type 2 Diabetes Mellitus (DM). 425 (84.0%) subjects had diabetic retinopathy. Moderate visual impairment, severe visual impairment and blindness due to diabetic retinopathy was observed in 139 (27.1%), 57 (11.1%), 76 (15%) subjects respectively while 234 subjects (46.2%) had normal vision. Hypertension 309 (61%) was the most common risk factor followed by duration of diabetes, occupation and the level of glycosylated Hemoglobin. 481 (95%) of the literate subjects were aware about diabetic retinopathy (P=<0.01). 277 (54.7%) subjects needed prompt treatment. There is a high prevalence of DR in patients attending Berhan Aini National Referral Hospital (BANRH). Awareness about diabetic retinopathy was good still the knowledge about primary prevention was not good enough.

2010 ◽  
Vol 3 (1) ◽  
Author(s):  
Irini P Chatziralli ◽  
Theodoros N Sergentanis ◽  
Petros Keryttopoulos ◽  
Nikolaos Vatkalis ◽  
Antonis Agorastos ◽  
...  

2003 ◽  
Vol 41 (143) ◽  
pp. 433-437
Author(s):  
Sudesh Subedi

Patient with diabetes mellitus have a higher prevalence of lens opacity 1and cataractdevelopment at an earlier age than non diabetic.2Cataract in diabetes mellitus decreasesthe visual acuity, makes posterior segment evaluation and laser treatment difficult.Several studies have shown that there is progression of diabetic retinopathy after cataractsurgery. In all studies, criteria for progression of diabetic retinopathy are:a) progression of any form/type or stage of diabetic eye (DE), nonproliferative diabeticretinopathy (NPDR) or proliferative diabetic retinopathy (PDR) to any advanced,recurrent form/ type or stage of NPDR or PDR andb) development of new clinically significant macular edema (CSME) and/or worsening/recurrent of preexisting CSME defined by Early Treatment Diabetic RetinopathyStudy (ETDRS).• More severe the preexisting diabetic retinopathy (DR), much worse the DR aftercataract extraction. The progression of DR after cataract extraction is severe inIntracapsular Cataract Extraction (ICCE) than Extracapsular Cataract Extraction(ECCE) with Intraocular Lens (IOL) and Sutureless Small Incision CataractSurgery (SICS) and Phacoemulcification.• Progression of DR increases with complicated cataract surgery, like posteriorcapsular rupture (PCR), vitreous loss and prolonged surgery.• The first 6 months period is crucial as a minimum period of follow up to detectprogression of DR.• There are other several local and systemic risk factors for the progression of DR,like hypertension, renal failure, ischemic heart disease, high cholesterol andtriglyceride level, pregnancy etc.Key Words: Diabetic retinopathy, cataract surgery, risk factors


2000 ◽  
Vol 6 (2-3) ◽  
pp. 313-325
Author(s):  
M. El Shazly ◽  
M. Zeid ◽  
A. Osman

A multicentre case-control study was conducted to identify and quantify risk factors that may influence the development and progression of diabetic retinopathy. A total of 200 diabetic patients with nonproliferative retinopathy were compared with 400 diabetic patients without any eye complications with regard to the development of diabetic retinopathy. They were also compared with 200 diabetic patients with major eye complications to study the progression of diabetic eye complications. Results showed that the progression of diabetic eye complications was preventable since all the variables significantly affecting the process of progression, except type of diabetes, were avoidable


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e023586 ◽  
Author(s):  
Ying Cui ◽  
Min Zhang ◽  
Liang Zhang ◽  
Lixin Zhang ◽  
Jian Kuang ◽  
...  

Research questionThe current population-based study aimed to investigate the prevalence of diabetic retinopathy (DR) and risk factors among residents over 40 years old in the rural area of Dongguan, southern China.Study designThe Dongguan Eye Study was a population-based study from September 2011 to February 2012.SettingThe area was set in the rural area of Dongguan, southern China.ParticipantsAdult rural population aged 40 or older.InterventionParticipants underwent haematological, physical, ophthalmic examinations and completed a questionnaire regarding lifestyles and systemic medical conditions.Primary and secondary outcome measuresThe frequency and risk factors of visual impairment and the major vision-threatening eye diseases.ResultsOf the 8952 Han Chinese, 1500 were diagnosed with type 2 diabetes mellitus (T2DM) with an average age of 59.5±11.1 years, and 1310 participants with fundus photography results were analysed. Standardised prevalence rate of DR was 18.2% for all patients with diabetes, 32.8% for the patients with previously diagnosed diabetes and 12.6% for newly diagnosed patients with T2DM. The prevalence rate of male DR was significantly higher than that of female DR (23.0% vs 14.1%, p<0.001). No significant difference was found in age-specific prevalence of DR. In diabetic patients, the prevalence rates of vision-threatening diabetic retinopathy, diabetic macular oedema and clinically significant macular oedema were 2.5%, 2.8% and 0.9%, respectively. Male gender, higher education level, longer duration of diabetes mellitus (DM), higher systolic blood pressure and glycosylated haemoglobin were independent risk factors for DR development in patients with diabetes.ConclusionA relatively lower prevalence of DR was found among the participants with T2DM in residents over 40 years in the rural area of southern China. Thus, an ophthalmic examination is recommended, especially for individuals with DM and DR risk factors. There is a need to increase awareness and education on DM and DR, especially in subjects with DR risk factors to reduce the incidence of DR and macular oedema.


2021 ◽  
Vol 7 (1) ◽  
pp. 24-28
Author(s):  
Wangchuk Wangchuk ◽  
Pem Chuki ◽  
Kinley Dorji ◽  
Tshering Dhendup ◽  
Nidup Dorji

Introduction: Diabetes mellitus (DM) is increasing the risk of pulmonary tuberculosis (PTB) with concern over the convergence of these two diseases. Although screening for PTB among people with DM has been recommended by WHO, it has not been implemented in Bhutan yet. Objective: The aim of this study was to determine the prevalence and risk factors of PTB among people living with DM at the National Referral Hospital (NRH), Thimphu, Bhutan. Methods: This was a cross-sectional study conducted from 1st June – 9th October 2018. All 343 consenting DM patients were screened for PTB using the WHO recommended questionnaire and those with TB positive symptoms were tested for active PTB using sputum smear microscopy and Gene-Xpert. A descriptive statistical analysis was performed using SPSS 21. Results: The prevalence of PTB among people living with DM was 0.87% (95% CI: 0.20-2.50).The mean age was 54.95 (± 13.2 years) and all were DM type II. The median duration of diabetes was 4 years (range of 0.1-40 years), an average level of HbA1c 7.47 (± 2.6), and median duration on DM medication was 4 years (range of 0.1-40 years) with the majority (88.9%) on oral hypoglycemic drugs. Good glycemic control (HbA1c< 7) was achieved by 39.4% of individuals. PTB risk factors included PTB positive symptoms (7.0%), prior PTB history (5.5%) and recent contact with PTB patient (5.0%). Additional known PTB risk factors were smoking (7.6%), alcohol use (4.1%) and low body mass index (1.5%). Conclusions: Although the prevalence PTB was low, health education, proper case management and risk based screening for PTB among DM is recommended.


2014 ◽  
Vol 10 (01) ◽  
pp. 30
Author(s):  
Nicola Pescosolido ◽  
Giuseppe Buomprisco ◽  
◽  

Retinopathy is a serious and common complication of diabetes that represents the leading cause of blindness, among people of working age, in developed countries. It is estimated that the number of people with diabetic retinopathy (DR) will increase from 126.6 million in 2011 to 191 million by 2030. The visual function that seems to be affected first in the course of DR is probably the contrast sensitivity; in addition, being mainly a macular function, the perception of color is also compromised. Moreover, the duration of the disease, the levels of glycated hemoglobin (HbA1c) and the presence of cystoid macular edema are strongly associated with the impairment of fixation stability in patients with diabetes with clinically significant macular edema, suggesting the possible diagnostic role of microperimetry. The test of contrast sensitivity and the microperimetry and the chromatic sensitivity tests have proved to be useful, safe, reproducible, and inexpensive tools to diagnose the


2021 ◽  
Vol 9 (3) ◽  
pp. 28-33
Author(s):  
S.Yu. Mogilevskyy ◽  
A.S. Hudz ◽  
Yu.O. Panchenko ◽  
O.V. Bushuyeva ◽  
G.E. Zakharevych

Background. According to the International Diabetes Federation, the number of people with diabetes mellitus is going to increase from 366 to 552 million by 2030. More than 1.5 million patients with diabetes are registered in Ukraine, of which 84–95 % have type 2 diabetes. Diabetic retinopathy (DR) is one of the common diabetes complications, being one of the leading causes of blindness and low vision, in particular in people of occupational age. Metabolic disorders, including activation of the polyol pathway of glucose utilization, play an important role in the pathogenesis of DR, with aldose reductase playing a key role, the activity of which is associated with the polymorphism of its gene, AKR1B1. The study of new meta­bolic and genetic mechanisms for the development and progression of DR in type 2 diabetes mellitus in patients from the Ukrainian population is an actual task of modern ophthalmology. Purpose: to investigate and generalize new genetically determined risk factors for diabetic retinopathy in type 2 diabetes mellitus. Materials and methods. The study involved 409 participants, who were divided into four groups: 1 — comparison cohort (98 people without diabetes mellitus type 2); 2 — 76 patients (stage I DR, without fundus chan­ges); 3 — 64 individuals with non-proliferative DR; 4 — 64 patients with proliferative DR; control group for genetic researches included 107 ophthalmologically healthy individuals. All patients underwent blood sampling for molecular genetic research by puncture of the ulnar vein and aspiration of 2.5 ml of blood through a 23G 5.0 ml disposable syringe (Hemoplast, Etalon+, Ukraine), followed by a release into a 3.0 ml container (Vacuette K3E K3EDTA, Greiner Bio-One, Austria). Distribution of polymorphic alleles and genotypes of rs759853 and rs9640883 aldose reductase gene (AKR1B1) in patients with non-proliferative DR, proliferative DR and in the control group and their association with disease and effects on the occurrence, mechanisms of development and progression of DR were studied. Based on the conducted researches, a model of DR development prognosis was developed by construction of multiple regression with sufficient reliability of degree of influence of independent variables on a calculated indicator. Results. As a result of our research, we identified new genetically determined risk factors for the development and progression of the different stages of DR in patients with diabetes mellitus type 2, namely the role of polymorphic alleles and genotypes rs759853 and rs9640883 of the AKR1B1 gene. The deve­loped logistic regression models found that the risk of DR incidence is five times lower in carriers of the G/G and G/A genotypes compared to carriers of the A/A genotype rs759853 polymorphism (p < 0.001). It was found that the risk is twice as high (p = 0.01) for carriers of the G/G genotype rs9640883 compared to the A/A + G/A genotypes. The risk of developing proliferative DR is 3.3 times lower in carriers of the G/G genotype and 2.5 times lower in carriers of the G/A genotype compared to carriers of the A/A genotype rs759853. Conclusions. Therefore, on the basis of our clinical, ophthalmological, molecular genetic and statistical studies we have identified new risk factors for the development and progression of different stages of DR in patients with diabetes mellitus type 2. Mathematical models of development and progression of different stages of DR in patients with diabetes type 2 were built.


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